Annexure 5A/3
ROYAL UNIVERSITY OF BHUTAN
EMPLOYMENT APPLICATION FORM
Post applied for:
College/Office applied for:
1. 1. PERSONAL DATA
Name:
Citizenship ID number:
Gender:
Date of birth:
Marital status:
Nationality:
Permanent residence:
Village:
Gewog:
Dzongkhag:
Contact number:
Email ID:
2. I have: (please tick if appropriate)
a. Not been convicted of a criminal offence;
b. Not been terminated or compulsorily retired from any agency except in case of
insolvency;
c. Not been adjudged medically unfit for employment by a competent medical doctor;
d. Not intentionally provided false information in this application for employment; and
e. Not furnished fake/forged testimonials/documents.
3. CURRENT POSITION, if employed
Position Title:
Position level: Department:
Organisation : Country:
4. EMPLOYMENT RECORD (Most recent employment first)
Employer's Institution/ Period of Service Position Main Roles and
1
Company Name From To with the Responsibilities
(dd/mm/yy (dd/mm/yy Institution/
) ) Company
5. EDUCATION (Please start with institute/college last attended and include information
as mentioned in the vacancy announcement)
Institution Aggregate Duration Educational
(University/College/School) marks Qualification
, city and country obtained From To
(mm/yyyy) (mm/yyyy)
PhD
Masters
Bachelors
[Link] (English plus
best three subjects)
Cl.X (English plus
best four subjects)
Others (Specify)…..
6. LANGUAGE SKILLS OF RELEVANCE TO THE ASSIGNMENT
(Mention your competency in relation to speaking, reading and writing) (Excellent, Very
Good, Good, Average)
Language Speaking Reading Writing
Dzongkha
English
7. TRAINING/SEMINAR/WORKSHOP/CONFERENCE (if attended)
Course Attended Institution/Agency, Period
City and Country From (mm/yyyy) To
(mm/yyyy)
8. RESEARCH PUBLICATIONS (if any)
(Research Papers, Books, Conference Papers, etc. if any, most recent publication first.)
2
Year: Title: Type: Publishe ISSN/ISBN
r
9. REFERENCE
Please provide contact details of two references for your application, at least one of which
should be a professional reference
Name:
Position Title: Organisation:
Relationship to Applicant:
Telephone: Mobile: E-mail:
Name:
Position Title: Organisation:
Relationship to Applicant:
Telephone: Mobile: E-mail:
10. DOCUMENTS (photocopy) TO BE ATTACHED TO THE APPLICATION:
a. Mark sheets & Certificates as announced;
b. Valid Bhutanese Citizenship Identity Card;
c. Valid Security Clearance Certificate;
d. Valid Medical Fitness Certificate; and
e. No Objection Certificate from the employer, if employed.
DECLARATION: I hereby declare that the information given herewith is true and complete
to the best of my knowledge. In the event of detection of false or misleading information, I
understand that the Royal University of Bhutan (RUB) shall withdraw/terminate my service
without any recourse; confiscate all my transcription/testimonials; debar from seeking
employment in the RUB; and prosecute in the Court of Law for legal actions. I also
undertake to abide by all Rules and Regulations.
Affix
Legal
Stamp
Name of the Applicant: For RUB use only
Signature:
Date: Received by Date:
Time: